A New Name for Borderline Personality Disorder (BPD)?
There has been numerous articles and discussion in the therapeutic community about renaming BPD. Here is the text of an interview with Dr. Leland Heller about a new name and about his feelings about the current Borderline Personality Disorder Name (the emphasis in this article is mine):
A POSSIBLE NEW NAME FOR BORDERLINE PERSONALITY DISORDER
Many people would like to change the terminology of the “borderline personality disorder” to a new term that more accurately describes the illness. The term “BPD” in and of itself is as if the whole person (and the personality) is flawed, rather than looking at the BPD as a medical problem it actually is.
The term “borderline personality disorder” implies that there is no hope for treatment as many mental health professionals unfortunately still believe. There is thought that this illness borders on schizophrenia, thus the term “borderline.”
What then is borderline personality disorder? These questions have been posed to Dr. Leland Heller, expert in treating borderline personality disorder.
Q. What do you think about the term “borderline personality disorder”?
A. “I think it’s a horrible, insulting label for a real medical illness. The name alone reduces serious research, stigmatizes victims, and implies the person is crazy. It denies the medical nature of the process, and implies simply a personality problem.”
Q. Do you think “borderline personality disorder” is an accurate description?
A. “No I don’t. It implies a character problem. While I’ve encountered many people with a bad character who had the BPD, most borderlines I’ve treated (over 2100) do not have character problems. “Borderline” means patients live “at the border” between psychosis and reality. When borderlines are well treated medically, psychotic experiences are few and far between – and can be treated well. Borderlines don’t live at that border, they simply go into psychosis too easily under stress.”
Q. What is the BPD?
A. “The BPD is a medical problem, likely a form of epilepsy (brain cells firing inappropriately and out of control). The characteristic symptoms include inappropriate moodiness, chronic anger, emptiness, boredom, dysphoria (anxiety, rage, depression and despair) and psychosis. The other criteria are symptoms related to these medical problems.
ALL neurological disorders can have an effect on the personality, such as Parkinson’s disease which isn’t called the ‘shaking personality disorder.’ ”
Q. What does this term “Dyslimbia” mean?
“ ‘Dys’ means malfunction, and limbia meaning from the limbic system.
‘Dyslimbia’ is malfunction of the limbic system. While other neuropsychiatric disorders involve malfunction of the limbic system, the limbic system dysfunction is profound in the BPD. I chose Dyslimbia for my patients to take the stigma away. The BPD needs a new name, one that emphasizes healing not labeling.
I don’t care if it’s renamed ‘Dyslimbia’ or not, but a more honest, humane, and hopeful name needs to be made for this illness. Patients deserve to get medical attention for ‘Dyslimbia’ (or an equivalent name), rather than have doctors and therapists shun them because they are ‘borderlines.’”
I’d like to write more about the struggle for a new name… but one of the things to note is that most researchers in this area have recommended dropping the word “personality” from the name and reclassifying it Axis I. The most common and likely new name is “Emotional Regulation Disorder (ERD).”
UPDATE: Well, the DSM-V has been previewed and it appears that the term “Borderline Type” is being considered.
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20 Comments
jordan
um, i gotta say, as someone with BPD, it really is not a bad, offensive name, if not perhaps even the perfect name. The mind is split in many aspects, it’s fractured, it’s on the fence, it is borderline. and as for the name destroying hope and possibility, it gives me some assurance just in the fact that there is a name for it-that there is a community of others suffering through the same thing-that i am not alone. the fact that it is just such a complicated disorder with such various effects and aspects, should not be looked down upon, and is also part of why I suppose some may take offense from sensitivity. But i really believe it is a great name for this horrible, complex problem.
Salma
I have BPD and i dont like the name at all. People think of BPD and think of and asume things that have nothing to do with the actual disorder. Ofcourse it is a really complex disorder and there is so much to it. But i really do think the name “borderline Personality” just dosent fit it. Borderline Disorder or even Emotional Regulation Disorder, I’ve even read Emotionally Unstable disorder, seems better than what it is now. Right now theres just too many misconceptions to it and im sure other people can relate to that.
It really does need a change. And more awareness this disorder is just as significant as bipolar , depression and any other mental health issue..
Why is just swept under the rug?
AV
It’s completely inaccurate that BPD is neurological issue. Although medications such as antidepressants help this somewhat, it’s primary method of recovery is through therapy in which so many have completely recovered from this. It is emotional vs. an organic brain disorder.
Bon Dobbs
Just because therapy helps, it doesn’t mean that there are no neurological issues. Intensive DBT has been shown to modify the brain pathways used when emotional stress is introduced. The current research has shown problems in the opiod and other neurochemical systems. I find it interesting that people accept that depression can be linked to serotonin issues and that SSRIs are effective, yet when BPD is considered, no acceptance of neurological dysfunction is accepted.
JI
How about saying they have a fractured personality.
Bon Dobbs
The point of this new name is to remove the idea of “personality” from the mix. While personality disorders will still be the classification in the DSM-V, it seems clear that BPD is not a personality disorder per se. It is an emotional regulation and impulsivity issue – in which emptiness and an unstable self exist – but the concept of a personality issue is pretty much off the table.
kevin blumer
i dont like the term borderline as a diagnoses i think they should rename it i dont think it describes it good enuff but how long would it take for a new name probaly years then everyone might not like the new name or adapt to it
phillip jansen (uk)
there is nothing wrong with having bpd.its not our fault people fail to understand us.keep the current name.just dont use u.k doctors.
Holly
I think we might be sensetive to any name.(HaHa) But BPD is ugly and sounds too much like Bipolar. Emotional Regulation Disorder stikes a home run for what I feel at times, and the inability to regulate emotions is the core to recovery. Who ever thought of this…nice work.
JJ
i think bpd shoud be renamed like it was said before there are too many negative associations with bpd the name has a definite stigma around it to people who have no idea what it is.. the overall stigma is a crazy person who terrorizes people, usually an ex after the ex ends their their relationship (i think the general public’s idea of someone with bpd is like glenn close’s character in fatal attraction, got to love what that dumb movie did for people who have a fear of abandonment) the movie just sensationalized and made the very serious issues associated with bpd into entertainment and made people with these issues seem like crazy people who kill , while some may, just like some people with bipolar may , or for that matter anyone in a highly emotional state may, a majority of people with bpd have ethical morals and do not hurt other people they would first hurt themselves . girl interrupted also failed to show the serious intense emotional pain people with bpd live with just about every single day . alot of people with bpd are also very empathetic and are very humanitarian and sensitive to other peoples suffering (for example Princess Diana, who is beleived to have had bpd and Angelina Jolie who is also beleived to have had bpd when she was younger. I am too very humanitarian and sensitiveto othe people’s suffering. I was diagnosed with bpd a few years ago when my ex broke up with me and I have been working very hard to try and change alot of the incorrect ideas my brain beleived in before alot of them are concerned mainly with boundaries i basicaly have realized that i had no boundaries whatsoever and did not even realize that i never took responsibility for how i felt, my emotions were completely dependent on how others saw me treated me, etc. i had to learn how to take sole responsiblity for my inner happiness and emotions . i still have fears that when iget into relationships i fall too easily back into enmeshment patterns i typed a lot of personal stuff that kind of veered from the topic BUT i also think that bpd is a combination of both emotional dysregulation/hypersensitivity and also may be caused by enmeshed and emotionally incestous relationships with parents/caretakers where the developing brain of a baby fails to separate itself from its mother (it remains to itself in a sybiotic state) there is a really good article about this i’ll post the link :
http://ccvillage.buffalo.edu/Abpsy/lecture18.html
JJ
just wanted to add that the general public needs to be made aware just how hard it is for a person with bpd every day is a struggle for the most part, people need to understand that having bpd is like living with no emotional skin, things that do not hurt other people or that would hurt other people slightly cause unbearable pain to those with bpd . i also wnt to say that there is alot of hope for people with bpd with therapy i think the brain has to relearn ideas and truths about people, relationships, etc , after the brain accepts thse new ideas emotions improve greatly, this worked for me the main ones were like i said earlier having your own idea of yourself and it has to be positive and not allowing anyone to be able to change how you see yourself and creating boundaries. researchers have also found that bpd tends to lessen in severity for alot of sufferers as they get older.
millie
i was diagnosed as ’emotionally unstable personality disorder’ which for me is as bad as bpd, it’s the ‘personality’ part i hate. it implies that there is something wrong with me as a person, when i’m just suffering. plus being called emotionally unstable doesn’t sound great either, but i suppose it is correct and i’m just going to have to accept it lol. emotional regulation disorder sounds much better.
PJ
This is like one of those “weasel word” wikipedia “articles”. Examples: ‘Many people would like to change the terminology…’ – who are these “many people”? ‘…as many mental health professionals unfortunately still believe.’ – Who are these “many mental health professionals”? ‘There is thought that this illness borders on schizophrenia…” – whose thought?
Vague comments about random individuals with no reference or explanation of who those people are. It would be like me writing an “artle” that said ‘Many people would like to kill the British Prime minister. Many mental health professionals support this view. There is the thought that Barack Obama is a lesbian in disguise.’
Bon Dobbs
I didn’t of course write the article. I just pasted an excerpt from the interview with Dr. Heller.
Tim
Honestly, my wife has it and she really is nucking futs. I’ve tried it all and I give up….
John
As someone who lived through 20 years of marriage to a person with this disorder, I must say that the insult suffered by a name cannot even remotely compare to the insults, pain, and suffering inflicted by the BPD person, on family. Such concern for the creators of so much damage leaves me quite cold and further insulted!
deborah beebe
After suffering 2 years with a bpd friend i feel that their brain is defective. I fled from her never looking back. Si x years ago she started using meth. This increased her paranoia and she died in jail in a holding cell 3 days ago. Her family is sad. B u t soon they will be relieved. Using her charm and beauty she convinced therapist after therapist that she was misunderstood someone should be in the room with the BPD so they can’t lie to the therapist. No. They dont get to change the name. People need to be warned. Sadly, my friend told me early into the friendship that one day I would run away from her. She was right.
Bon Dobbs
Deborah,
That’s a sad story. I find it tragic that some people with BPD would rather suffer and die than be truthful to others and accept real help.
Bon
Bernice
What about Emotional Intensity Dysfunction. I cannot stand the BPD label and I have told only 4 people in my life that I have it. I feel like they have to know me very well as a person for me to say anything because otherwise I will be perceived as having a flawed personality. All I want to do is help people and ironically I am studying an Ma in the psychotherapeutic field but I am terrified how my behaviour would be perceived if more people knew. I can be a loud, happy and fun filled person, but……is this perceived as some kind of mania just because I now have this label attached to me????
I am currently struggling with a lot of these dilemmas. Life is hard enough as it is without the added pressure of running away from this miss-labelled, misunderstood diagnosis. I am sad….
Valentine
Personality disorder certainly implies bad person . I too never say real diagnoses. I lie feeling bad and just say depression. I also got tagged with hysteronic personality disorder.The latter primarily is applied to women. I have enough assets and ego now to see how sexist this.Drug and alcohol abuse are common in lots of “mental cases. I overcame alcoholism in my 20’s.Born in the 50’s 3 mo. premature.Lucky to be alive;legally blind in one eye,atrophy in rt.side.Boo hoo~I am stable and successful with joys. Is it a struggle at times..YES.Do I think birth issues are contributing..ABSOLUTELY.Younger I could never find a doctor who heard me say extreme pms.These issues are at the forefront now because of Amber Heard